Abstract:
This narrative review examines recent theoretical developments in psychology and evaluates their potential application within the Syrian context following the fall of the Assad regime in December 2024.
The review surveys five contemporary theories: predictive processing, intersubjective active inference, the SHARE model for treating cultural trauma, collective post-traumatic growth, and logotherapy. It also critically evaluates these theories and discusses their methodological and practical limitations.
The review concludes that building a mental health system in post-conflict Syria requires a multi-level approach combining integration into primary care, community-based group psychotherapy, transitional justice, school-based programs, and professional capacity building. Finally, it proposes a framework for a national mental health policy.
Review Methodology:
Review Type: A non-systematic narrative review aimed at providing a conceptual synthesis of modern psychological theories and assessing their applicability to the Syrian context.
Search Strategy: Searches were conducted across PubMed, Google Scholar, and Scopus databases using Arabic and English terms, including: “mental health Syria,” “collective trauma,” “post-conflict recovery,” “predictive processing,” “SHARE model trauma,” “logotherapy,” and “community psychology.”
Searches also extended to Arabic and Syrian sources to obtain up-to-date local data.
Selection Criteria: Sources were selected based on recency (predominantly 2020–2026), direct relevance to the topic, and academic credibility. Peer-reviewed sources were prioritized for the literature review, supplemented by reliable media sources for local statistical data where academic sources were unavailable.
Methodological limitations: This review does not follow the PRISMA protocol used for systematic reviews, nor does it include quantitative analysis or a synthesis of findings.
Furthermore, most field studies concerning Syria rely on cross-sectional or qualitative data, which limits generalizability.
Moreover, assessing the effectiveness of therapeutic interventions in the Syrian context remains limited due to a scarcity of experimental studies in a post-conflict setting.
Introduction:
The world observes World Mental Health Day on October 10th each year. In Syria today—following the fall of the Assad regime in December 2024 and the onset of a complex transition period—this reminder has become more urgent than ever.
After more than fourteen years of armed conflict, systemic repression, displacement, detention, and torture, the Syrian people are suffering from deep psychological wounds that are no less severe than the physical destruction inflicted upon the country’s infrastructure.
A study by Kakaje et al. (2021), involving 1,951 participants in Syria, indicates that 44% of respondents were likely suffering from severe mental disorders resulting from the war and other factors, such as a lack of social support. Recent data indicate that over 85% of Syrian university students have experienced at least one traumatic event, and 40.62% meet the diagnostic criteria for probable post-traumatic stress disorder (PTSD). Furthermore, World Health Organization estimates suggest that one in ten Syrians suffers from a mild to moderate mental health condition, while one in thirty suffers from a more severe condition.
In contrast, the total number of psychiatrists across Syria does not exceed 75—translating to one psychiatrist for every 250,000 people—a figure far below the recommended global standard.
Experts estimate that Syria requires at least 10,000 mental health professionals to meet actual needs.
This article aims to provide a critical review of the latest theories in modern psychology, outline its key types and schools of thought, and discuss the potential for applying this knowledge to the project of rebuilding the Syrian individual and society in the post-Assad era.
Latest Theories in Modern Psychology (A Critical Perspective):
Predictive Processing Theory:
Predictive processing theory is one of the most influential theories in contemporary psychology; it posits that the brain continuously generates predictions about sensory inputs based on past experiences, aiming to anticipate and respond effectively to the environment.
When actual experience diverges from expectation, “prediction errors” arise, prompting the brain to update its internal model of the world. In cases of psychological distress, deeply ingrained negative expectations may persist—despite their harmful nature—because they offer temporary relief from uncertainty.
This framework is particularly significant in the context of collective trauma, where individuals internalize negative predictive models regarding safety, trust, and others following years of violence and oppression.
Critique of the Theory: Predictive processing theory faces fundamental criticisms.
Critical reviews suggest that it “fails to provide general, simple, coherent, and systematic explanations” and that the models based on it “exhibit clear contradictions with its stated principles.”
Furthermore, its applications in psychiatry often “rely on implicit normative assumptions,” such as using Western concepts of the self as ideal benchmarks for neurocognitive functioning.
Moreover, some critics argue that the theory veers toward “Kantian transcendental idealism” by positing that we experience the world only as it appears rather than as it truly is—thereby undermining its naturalistic and realist claims.
Active Intersubjective Inference:
Harris (2025) developed a framework integrating psychodynamic theory with predictive processing to explain the construction of self-identity and psychological disorders.
This framework posits that the self emerges from repeated inferences regarding how others perceive us—termed the “second-order self”—and interacts bidirectionally with internal receptive processes. Distortions in these second-order inferences constitute a fundamental impairment in cases of depression and post-traumatic stress disorder (PTSD), thereby opening the door to integrative therapeutic interventions.
However, this framework does not… It remains in the stage of theoretical development; there are not yet sufficient empirical studies demonstrating its therapeutic efficacy across diverse clinical settings, let alone in contexts of collective trauma.
The SHARE Model for Treating Cultural Trauma:
Given that Syria is a collectivist society that values the group, family, and a sense of belonging, therapeutic models imported from individualistic Western contexts may prove inadequate.
Consequently, the SHARE model offers a psychoanalytic framework that addresses the specific cultural nuances of collectivist societies.
The model comprises five interconnected dimensions: Silence, Honor, Attachment, Relational Trauma, and Embodied Memory.
This model posits that, in contexts of oppression and conflict, silence can function simultaneously as a defense mechanism and a survival strategy, rather than merely representing an inability to express oneself.
It redefines trauma as a culturally encoded phenomenon that persists across generations through family dynamics, silence linked to shame, and collective repression.
The model’s value and limitations: The SHARE model is distinguished by its high degree of cultural sensitivity, making it more suitable for the Syrian context than purely Western models.
However, it remains a theoretical conceptual framework that has not yet undergone extensive empirical testing in Arab post-conflict settings; thus, caution is warranted regarding assumptions of its efficacy prior to conducting field studies within Syria.
Collective Post-Traumatic Growth:
In contrast to the traditional view that focuses solely on pathological symptoms, the concept of collective post-traumatic growth offers a positive perspective, acknowledging the capacity of communities to evolve and grow following catastrophic experiences.
This concept is defined as “perceived positive changes at the societal level following collective trauma.”
The “healing-through-justice” approach proposes a transformative strategy aimed at fostering collective post-traumatic growth through youth empowerment, action, and systemic change.
Critique of the concept: It is worth noting that the concept of post-traumatic growth is not universally accepted.
Some researchers argue that self-reported “growth” may not reflect genuine psychological improvement; instead, it could be a coping mechanism or even a form of “collective false consciousness.”
Furthermore, measuring collective growth presents significant methodological challenges, particularly in post-conflict contexts where wounds remain open.
Existential Hope and Logotherapy:
Recent studies have demonstrated that existential hope plays a pivotal role in the social recovery of communities emerging from humanitarian crises.
Existential hope is positively associated with—and uniquely predicts—social cohesion, the restoration of trust, and collective engagement, even when controlling for the level of collective suffering.
Logotherapy is grounded in Viktor Frankl’s theory, which asserts that human beings can endure suffering if they find meaning in it. This approach has been successfully applied to various groups, including Ukrainian refugees and veterans suffering from post-traumatic stress disorder (PTSD).
However, its application within the Syrian context requires cultural adaptation that respects the religious and social specificities of Syrian society.
Types and Schools of Psychology:
Psychology is traditionally divided into various schools, each offering a different lens through which to understand human behavior and psychological distress.
These schools include psychoanalysis, behaviorism, cognitivism, humanism, positive psychology, and community psychology.
It is worth noting that these schools are not necessarily mutually exclusive; rather, they can complement one another within comprehensive therapeutic approaches.
In the context of the collective trauma experienced in Syria, for instance, integrating cognitive-behavioral therapy (for acute symptoms), community-based therapy (for social cohesion), and logotherapy (for existential restoration) may prove more effective than relying on a single school of thought.
The Specific Nature of Collective Trauma in the Syrian Context:
Before turning to practical applications, it is essential to understand the unique nature of the Syrian situation.
Studies indicate that the collective trauma in Syria differs from trauma resulting from external wars; it stems from the “tyranny and excessive encroachment of an internal despot,” a situation in which institutions transformed from protectors into aggressors, and where corruption, denunciation, and institutional betrayal became rampant. Collective trauma manifests across three layers: the individual psychological layer (chronic anxiety, phobias, and eroded confidence), the social layer (institutional collapse and the fraying of social ties), and the cultural and identity-related layer (distorted collective memory and conflicting narratives). Consequently, any therapeutic approach to trauma in Syria must be multi-level.
Practical Applications:
Integration into Primary Health Care:
One of the key lessons learned from post-conflict nations is that mental health services should be integrated into primary health care rather than remaining isolated within specialized hospitals.
A study published in The Lancet (2025) suggested that rebuilding psychological resilience in post-conflict Syria requires using primary care as a platform for delivering mental health services, while simultaneously expanding access to rural areas through mobile units.
Community-Based Group Psychotherapy:
Rwanda’s experience following the 1994 genocide offers a model adaptable to the Syrian context.
“Community Sociotherapy” is based on the principle of Mvura Nkuvure (“Heal me, and I will heal you”). It employs a six-stage process—encompassing safety, trust, care, respect, reorientation toward a new life, and the processing of memories—aimed at creating safe communal spaces where participants can share their experiences, rebuild their dignity, and restore their sense of belonging. Quantitative results in Rwanda showed a 17.2% increase in intergroup trust, a 12.5% increase in social cohesion, and a 9.5% increase in willingness to forgive, resulting in a 34.5% increase in willingness to cooperate.
Participants’ psychological well-being also rose from 74.4% before the interventions to 80.4% afterwards.
However, the Rwanda experience…Significant challenges also exist, including limited geographic coverage, resource constraints, and the inability to reach all individuals and communities in need.
Furthermore, survivors often continue to grapple with unresolved trauma, while released perpetrators face stigma and reintegration difficulties.
This implies that transferring this experience to Syria requires meticulous planning that takes contextual differences into account.
Transitional Justice as a Prerequisite for Psychological Healing:
No psychological treatment can succeed in an environment that lacks acknowledgment of wounds and justice for victims.
Amnesty International (2025) notes that survivors of the Syrian detention system—including inmates of Saydnaya Prison—”suffer from devastating health and psychological consequences amidst a severe lack of support” and “require immediate medical, psychosocial, and legal support.”
Syria has taken institutional steps in this direction; Decree No. 20 was issued on May 17, 2025, mandating the establishment of the National Commission for Transitional Justice.
The Commission also signed a memorandum of understanding with the Center for Victims of Torture (CVT) to enhance cooperation in psychosocial support and capacity building.
However, these steps are still in their early stages and require specialized, systematic psychological support to ensure that transitional justice is accompanied by psychological healing, rather than remaining merely a legal procedure.
School-Based Mental Health Programs:
Children and youth are among the groups most affected by collective trauma. A study by The Lancet indicates that protecting future generations requires “addressing intergenerational trauma through psychoeducation for parents, caregivers, and schools, and ensuring early interventions for at-risk children.”
A national mental health strategy must include school-based programs that focus on positive mental health, life skills, coping mechanisms, and the early detection of mental health issues, while also providing child- and woman-friendly spaces.
Youth Empowerment and Community Engagement:
The “Healing through Justice” model demonstrates that youth empowerment, collective action, and systemic change are essential pathways for fostering growth following collective trauma.
This can be translated into practical programs that include supporting youth-led mental health initiatives, training young people as psychosocial intermediaries, and involving them in the design and implementation of community recovery programs.
This approach aligns with recent literature in community psychology, which emphasizes the importance of community participation in the design—not merely the implementation—of interventions.
Professional Capacity Building and Scientific Research:
No mental health strategy can be implemented without the necessary human and professional infrastructure.
The Lancet notes that “the number of trained mental health professionals must increase” and highlights “numerous obstacles that could hinder the rehabilitation of Syria’s mental health system,” including the shortage of local professionals. This requires training a sufficient number of psychiatrists, psychologists, and social counselors; establishing specialized trauma and group therapy units within Syrian universities; and conducting field research to assess the current burden of mental illness in Syria.
Towards a National Mental Health Policy:
Based on the above, the Medical Office of the Syrian Future Movement proposes the following framework for a national mental health policy:
Declaring mental health a national priority and potentially incorporating it into constitutional reform documents and development policies.
Establishing a national body for mental health and psychosocial support, comprising representatives from the Ministries of Health, Education, and Social Affairs, as well as civil society organizations and Syrian experts in the diaspora.
Developing a national community-based group psychotherapy program modeled on the Rwandan experience but adapted to Syria’s specific cultural context.
Integrating mental health into primary healthcare and school systems by training primary care physicians, teachers, and counselors in early detection and initial intervention.
Launching public psycho-education programs to destigmatize mental illness.
Linking transitional justice with psychological healing, ensuring that transitional justice mechanisms are accompanied by specialized psychological support for survivors.
Developing human resources and scientific research by establishing specialized university programs and conducting periodic national mental health surveys.
Conclusion:
Amidst discussions on rebuilding infrastructure, we must not overlook the need to rebuild the human being. Modern psychological theories—ranging from predictive processing and the SHARE model to collective post-traumatic growth—offer precise scientific tools for understanding and treating the wounds of the Syrian people.
However, understanding alone is insufficient; what is required is political will, investment in human capital, and integration among the public sector, civil society, and international institutions.
The Syrian people, having endured the most severe forms of oppression and trauma, are capable—given the necessary support—of overcoming their wounds and building a resilient, cohesive society.
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